{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T04:28:21Z","timestamp":1790310501810,"version":"4.1.0"},"reference-count":22,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T00:00:00Z","timestamp":1750032000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Research Council of the University of Patras"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Patients on standard hemodialysis (HD) show insufficient clearance of medium-molecular-weight uremic toxins, resulting in long-term complications. In this study we investigated the effectiveness of expanded HD (xHD) in the clearance of medium-molecular-weight uremic substances. This prospective study included patients on standard thrice-weekly HD. Participants were treated with xHD for 4 weeks, and the clearance of urea and \u03b22-microglobulin was measured at the beginning and at the end of the study and compared with standard HD (sHD). Moreover, we investigated the clearance of Su-PAR, MCP-1, and activin, comparing sHD, xHD, and online hemodiafiltration (HDF). xHD had the same efficiency in the removal of low-molecular-weight substances compared to sHD but led to a significant decrease in \u03b22-microglobulin levels from the first application of the method (sHD: from 36.9 \u00b1 10.6 to 39.7 \u00b1 18.9 mg\/dL, p = 0.595 vs. 1st xHD: from 40 (36.5, 41.8) to 11 (9.8, 13.2) mg\/dL, p = 0.008 vs. after 4 weeks on xHD: from 31.5 (28.5, 34.5) to 8.7 (8.2, 9.0) mg\/dL, p = 0.008). Moreover, pre-session \u03b22-microglobulin levels significantly decreased after 4 weeks on xHD. Su-PAR, MCP-1, and activin during xHD were also significantly reduced. xHD leads to a significant and cumulative reduction in medium-molecular-weight uremic toxins compared to standard HD.<\/jats:p>","DOI":"10.3390\/ijms26125747","type":"journal-article","created":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T10:47:22Z","timestamp":1750070842000},"page":"5747","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Efficacy of Expanded Hemodialysis and Comparison with Standard Hemodialysis and Online Hemodiafiltration"],"prefix":"10.3390","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0530-7816","authenticated-orcid":false,"given":"Adamantia","family":"Bratsiakou","sequence":"first","affiliation":[{"name":"Department of Nephrology and Kidney Transplantation, University Hospital of Patras, School of Medicine, University of Patras, 26504 Patras, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9375-989X","authenticated-orcid":false,"given":"Marios","family":"Papasotiriou","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Kidney Transplantation, University Hospital of Patras, School of Medicine, University of Patras, 26504 Patras, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panagiota","family":"Davoulou","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Kidney Transplantation, University Hospital of Patras, School of Medicine, University of Patras, 26504 Patras, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6130-7100","authenticated-orcid":false,"given":"Georgia Andriana","family":"Georgopoulou","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Kidney Transplantation, University Hospital of Patras, School of Medicine, University of Patras, 26504 Patras, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7162-9805","authenticated-orcid":false,"given":"Evangelos","family":"Papachristou","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Kidney Transplantation, University Hospital of Patras, School of Medicine, University of Patras, 26504 Patras, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios S.","family":"Goumenos","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Kidney Transplantation, University Hospital of Patras, School of Medicine, University of Patras, 26504 Patras, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,16]]},"reference":[{"key":"ref_1","first-page":"I","article-title":"The Rise of Expanded Hemodialysis","volume":"44","author":"Ronco","year":"2017","journal-title":"Blood Purif."},{"key":"ref_2","first-page":"S87","article-title":"Long-term outcome in hemodialysis: Morbidity and mortality","volume":"17","author":"Pozzoni","year":"2004","journal-title":"J. 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